Photodynamic therapy for high-grade dysplasia in Barrett's esophagus is a Food and Drug Administration-approved alternative to esophagectomy.
Critical information regarding overall survival of patients followed up long-term after these therapies is lacking.
Dr Kenneth Wang and colleagues from Minnesota evaluated the long-term survival of patients treated with photodynamic therapy.
The investigative team compared these with patients treated with esophagectomy.
The research team reviewed records of patients with high-grade dysplasia between 1994 and 2004.
|Overall mortality in the photodynamic therapy group was 9%|
Photodynamic therapy was performed 48 hours following the intravenous administration of a photosensitizer using light at 630 nm.
Esophagectomy was performed by either transhiatal or transthoracic approaches by experienced surgeons.
The investigators excluded all patients with evidence of cancer on biopsy specimens.
Vital status and death date information was queried using an institutionally approved Internet research and location service.
The team performed statistical analysis using Kaplan-Meier curves and Cox proportional hazards ratios.
The investigators identified a total of 199 patients.
The team treated 129 patients with photodynamic therapy, and 70 with esophagectomy.
Overall mortality in the photodynamic therapy group was 9% over a median follow-up of 60 months.
The investigators found that overall mortality in the surgery group was 9% over a median follow-up period of 61 months.
Overall survival was similar between the 2 groups.
The team noted that treatment modality was not a significant predictor of mortality on multivariate analysis.
Dr Wang's team concludes, "Overall mortality and long-term survival in patients with high-grade dysplasia treated with photodynamic therapy appears to be comparable to that of patients treated with esophagectomy."